Individual
KENDRA STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, DNP-FNP STUDENT
Contact information
Practice address
4415 S HARVARD AVE STE 120, TULSA, OK 74135-2616
(918) 895-7850
Mailing address
456 E 130TH PL S, JENKS, OK 74037-4437
(405) 464-0910
(405) 464-0910
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
224395
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/10/2025
Last updated
07/10/2025
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